脂肪肝指数与心肌重构的关联性分析

Analysis of the correlation between fatty liver index and myocardial remodeling

目的:分析脂肪肝指数(FLI)与心肌重构的关联性。方法:横断面研究,2015年4至9月采取整群抽样的方法对北京古城及苹果园两个社区居民进行“中国2型糖尿病患者肿瘤发生风险的流行病学研究(REACTION)”的随访研究,根据纳入及排除标准,共筛选出8848人为研究对象,获取体重指数、腰围、甘油三酯、γ-谷氨酰转移酶等生化指标,并计算FLI。彩色多普勒超声仪检测室间隔厚度(IVS)、左心房内径(LAD)、左心室舒张末期内径(LVEDD),以及是否存在舒张功能减退。根据FLI三分位数分为Q1组(FLI<30,4529例),Q2组(30≤FLI<60,2762例),Q3组(FLI≥60,1557例)。采用单因素方差分析进行组间比较,采用logistic回归分析FLI与心肌重构的关联性。结果:8848人中男性3110人,女性5738人,平均年龄59.96岁。Q1、Q2、Q3组IVS分别为(9.35±1.08)、(9.73±1.22)、(10.07±1.31)mm,LAD分别为(30.94±3.92)、(33.37±4.12)、(34.98±4.47)mm,LVEDD分别为(42.51±5.05)、(44.43±5.10)、(46.06±5.52)mm,总体上随着FLI的升高而升高(均P<0.001)。FLI是IVS增厚、LAD增宽、LVEDD增宽、舒张功能减退的独立危险因素,FLI Q2及Q3组人群发生IVS增厚、LAD增宽、LVEDD增宽、舒张功能减退的风险分别是Q1组人群的1.62倍(95%CI 1.39~1.89)及2.53倍(95%CI 2.13~3.00)、2.71倍(95%CI 2.39~3.06)及5.00倍(95%CI 4.12~6.08)、2.36倍(95%CI 1.85~3.00)及4.33倍(95%CI 3.33~5.62)、1.90倍(95%CI 1.63~2.19)及1.95倍(95%CI 1.60~2.37)。结论:FLI与心肌重构的出现有一定关联性。

Objective To analyze the correlation between fatty liver index(FLI)and myocardial remodeling.Methods For cross-sectional study,cluster sampling was used to conduct a follow-up study of“Risk evaluation of cancers in Chinese diabetic individuals:A longitudinal(REACTION)study”among communities of Gucheng and Pingguoyuan of Beijing from April 2015 to September 2015.According to the inclusion and exclusion criteria,8848 participants were selected.Biochemical indicators such as body mass index,waist circumference,triglycerides,andγ-glutamyl transpeptidase were detected to calculate the FLI.The correlation between FLI and myocardial remodeling was analyzed.Interventricular septal thickness(IVS),left atrial diameter(LAD),left ventricular end diastolic diameter(LVEDD),and the presence of diastolic dysfunction were measured by color doppler ultrasound.The participants were divided into Q1 group(FLI<30,4529 cases),Q2 group(30≤FLI<60,2762 cases),and Q3 group(FLI≥60,1557 cases)based on FLI levels.Single factor analysis of variance was used for inter-group comparison,logistic regression analysis was used to analyze the correlation between FLI and myocardial remodeling.Results A total of 8848 subjects were selected for the study(3110 male and 5738 female,mean age:59.96 years).The IVS of Q1,Q2,and Q3 groups were(9.35±1.08),(9.73±1.22),and(10.07±1.31)mm,respectively.The LAD were(30.94±3.90),(33.37±4.12),and(34.98±4.47)mm,respectively.The LVEDD were(42.51±5.05),(44.43±5.10),and(46.06±5.52)mm,respectively.All increased with the increase of FLI(all P<0.001).FLI was an independent risk factor for IVS thickening,LAD increase,LVEDD increase,and diastolic function decrease.The respective risks for IVS thickening,LAD increase,LVEDD increase,and diastolic function decrease in a population with intermediate and higher FLI levels was 1.62 times(95%CI 1.39-1.89)and 2.53 times(95%CI 2.13-3.00);2.71 times(95%CI 2.39-3.06)and 5.00 times(95%CI 4.12-6.08);2.36 times(95%CI 1.85-3.00)and 4.33 times(95%CI 3.33-5.62);and 1.90 times(95%CI 1.63-2.19)and 1.95 times(95%CI 1.60-2.37)than those with lower FLI levels.Conclusion There is a certain relevance between FLI and myocardial remodeling.